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Episode 537

Physicians as the Sleeping Giant—Why Many Doctors Don't Push Back and Some Advice, With Benjamin Schwartz, MD, MBA

Relentless Health Value · 35 min

Episode Description

Waking the Sleeping Giant of Physicians: Why Doctors Stay Quiet and Where They Can Gain Leverage. Episode 537.

Waking up the sleeping giant that is physicians. Employers have been called the sleeping giant of healthcare for years, so if employers are sleeping giants, why not physicians? In this episode, Stacey Richter talks with Benjamin Schwartz, MD, MBA, an orthopedic surgeon who sees patients at a safety net system, works as a medical director at a musculoskeletal (MSK) company, and writes the Substack The Surgeon's Record, about why it is actually pretty tough for many docs to grab the reins and gallop off in a different direction — and the directional ways forward despite the obstacles.

WHAT YOU'LL LEARN

✅ Why most physicians are now employed, and why without an alternative there is no leverage to fight back

✅ The real risks to an overly loud doctor: contract non-renewal, revoked or suspended privileges, and disciplinary action on a permanent record

✅ How noncompetes, rebuilding a referral base, the lost art of succession planning, med school competitiveness, and budget neutrality keep physicians fragmented

✅ How to do dyad leadership right so physician leaders keep trust with the bedside instead of being seen as the enemy

✅ Why a physician-led MSO (managed services organization) differs from an investor-backed MSO looking for an exit: the concept is neither positive nor negative, it is in the implementation

✅ Where ASC (ambulatory surgical center) ownership, direct contracting with employers, and collective action fit, plus Dr. Schwartz's simplest first step: educate yourself

WHY THIS MATTERS

Doctors are the ultimate deliverers of care, yet Stacey notes that for every physician picking up a torch, there are, like, a thousand others who don't seem to be. The reasons are structural: employment as the perceived-safe default, noncompetes, a zero-sum payment pool, and training focused on the one patient in front of you. As Stacey says, no one is coming to save us, so if anything is going to happen, it needs to be the individuals who desire change picking up a torch.

MENTIONED IN THIS EPISODE

EP523 with Suhas Gondi, MD, MBA: Apple Podcasts | Spotify | Other Apps

Article: New England Journal of Medicine, by Zirui Song, MD, PhD, and Suhas Gondi, MD, MBA

EP406 with Lauren Vela: Apple Podcasts | Spotify | Other Apps

EP508 with Lee Lewis: Apple Podcasts | Spotify | Other Apps

EP491 with Elizabeth Mitchell: Apple Podcasts | Spotify | Other Apps

EP474 with Yashaswini Singh, PhD: Apple Podcasts | Spotify | Other Apps

LinkedIn Post by Graham Walker, MD

EP536 with Rebecca Andrews, MD: Apple Podcasts | Spotify | Other Apps

EP404 with Suhas Gondi, MD, MBA: Apple Podcasts | Spotify | Other Apps

EP481 with Benjamin Schwartz, MD, MBA: Apple Podcasts | Spotify | Other Apps

EP529 with Eric Bricker, MD: Apple Podcasts | Spotify | Other Apps

LinkedIn Post by Christopher Habig

EP521 with Andrew Tsang: Apple Podcasts | Spotify | Other Apps

EP294 with Steve Schutzer, MD: Apple Podcasts | Spotify | Other Apps

Website: The Surgeon's Record (Substack by Dr. Schwartz)

=== LINKS ===

🔗 Show Notes with all mentioned links.

📝 Read Dr. Schwartz's Substack, The Surgeon's Record

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=== CONNECT WITH THE RHV TEAM ===

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00:00 Introduction to this episode.

04:55 The conversation with Benjamin Schwartz, MD, MBA.

05:05 "Waking up" the sleeping giant of physicians.

07:40 The risks to a doctor who speaks up.

11:35 How going independent has changed for young doctors.

19:34 Bridging the world between physicians and healthcare administration.

21:40 What the next version of independent healthcare looks like.

23:20 What MSOs are and how they play into independent practice.

25:38 Where ASCs play into independent practice.

26:51 The potential for direct contracting in independent practices.

30:55 Where collective action might fit into this.

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